老年患者子宫内膜癌的腹腔镜手术：来自中国东部一家三级转诊中心的经验

Laparoscopic surgery for endometrial cancer in aged patients: Experience from a tertiary referral center in Eastern China.

作者信息

Liu Song-Ping, Cheng Xiao-Wei, Tian Xin, Zhang Qiong, Cui Hong-Yan, Hua Ke-Qin

机构信息

Department of Obstetrics and Gynecology, Zhenjiang Maternal and Child Hospital, Zhenjiang, Jiangsu 212001; Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200090, China.

Department of Obstetrics and Gynecology, The Fourth People's Hospital of Changzhou, Changzhou, Jiangsu 213001, China.

出版信息

J Cancer Res Ther. 2017;13(5):761-766. doi: 10.4103/jcrt.JCRT_417_17.

DOI:10.4103/jcrt.JCRT_417_17

PMID:29237900

Abstract

OBJECTIVE

The aim of the present study was to evaluate the feasibility and safety of laparoscopic surgery for endometrial cancer in aged patients and show the experiences of laparoscopic surgery for elderly endometrial cancer patients in Eastern China.

MATERIALS AND METHODS

A total of 211 patients (≥60 years) with endometrial carcinoma treated with surgery were retrospectively analyzed, including 104 patients who underwent laparoscopic surgery, and 107 who underwent laparotomy.

RESULTS

The operation time was similar in both groups (192.9 vs. 185.5 min, P = 0.722). For all cases, the estimated blood loss was less in the laparoscopic group relative to that of in the open group (227.5 vs. 382.6 ml, P = 0.000). There was no difference in the complication rate between the two groups (21.2% vs. 29.0%, P = 0.191). Overall, right pelvic and periaortic lymph node dissections were similar for the laparoscopic and laparotomy groups, but the former procedure dissected more left pelvic lymph nodes than that of in laparotomy (13.3 vs. 7.2 nodes, P = 0.038). The hospital stay was shorter after laparoscopic surgery than that of after laparotomy (7 vs. 10.5 days, P = 0.000). The recurrence rate was similar in the two groups (7.7% vs. 10.3%, P = 0.511).

CONCLUSIONS

Laparoscopy could be a safe alternative to laparotomy for endometrial cancer in aged patients.

摘要

目的

本研究旨在评估老年患者子宫内膜癌腹腔镜手术的可行性和安全性，并展示中国东部地区老年子宫内膜癌患者腹腔镜手术的经验。

材料与方法

回顾性分析211例接受手术治疗的子宫内膜癌患者（年龄≥60岁），其中104例行腹腔镜手术，107例行开腹手术。

结果

两组手术时间相似（192.9分钟对185.5分钟，P = 0.722）。所有病例中，腹腔镜组估计失血量低于开腹组（227.5毫升对382.6毫升，P = 0.000）。两组并发症发生率无差异（21.2%对29.0%，P = 0.191）。总体而言，腹腔镜组和开腹组的右盆腔及腹主动脉旁淋巴结清扫情况相似，但腹腔镜组清扫的左盆腔淋巴结多于开腹组（13.3枚对7.2枚，P = 0.038）。腹腔镜手术后住院时间短于开腹手术（7天对10.5天，P = 0.000）。两组复发率相似（7.7%对10.3%，P = 0.511）。